摘要
目的比较超声引导下糖皮质激素注射与传统封闭治疗类风湿关节炎(RA)的疗效。方法前瞻性选择明确诊断为RA的患者86例,根据患者意愿进行分组,其中传统封闭治疗组43例,超声介入治疗组43例。比较治疗前后两组的关节疼痛程度、腕、踝关节积液以及关节滑膜最大厚度。进行为期18个月的随访,Kaplan-Meier生存曲线记录并比较两组患者的复发情况。结果治疗12周内两组滑膜厚度和视觉模拟评分(VAS)均呈现下降趋势(P <0. 05)。超声介入治疗组关节滑膜厚度和VAS低于传统封闭治疗组,差异有统计学意义(P <0. 05)。治疗后12周两组关节积液检出率较治疗前显著降低,差异有统计学意义(P <0. 05),其中超声介入治疗组低于传统封闭治疗组,差异有统计学意义(P <0. 05)。超声介入治疗组远期复发率低于传统封闭治疗组,差异有统计学意义(P <0. 05)。结论高频超声引导下介入治疗可以明显改善RA患者腕、踝关节的病变,降低复发率。
Objective To compare the efficacy of ultrasound-guided glucocorticoid injection with traditional closed therapy for rheumatoid arthritis.Methods A total of 86 patients with RA diagnosed in our hospital were prospectively recruited.According to the patient's wishes,43 patients were in the traditional closed treatment group and 43 patients were in the ultrasound intervention group.The degree of joint pain,wrist and ankle effusion,and synovial thickness were compared between the two groups before and after treatment.An 18-month follow-up was performed and Kaplan-Meier survival curves were recorded and compared for recurrence in both groups.Results The synovial thickness and VAS of the two groups showed a downward trend within 12 weeks(P<0.05).The synovial thickness and VAS of the ultrasound intervention group were lower than those of the conventional closed treatment group.The differences were statistically significant(P<0.05).The detection rate of joint effusion in the two groups was significantly lower than that before treatment at 12 weeks after treatment(P<0.05).The detection rate of joint effusion in the ultrasound intervention group was lower than that in the traditional closed treatment group(P<0.05).The long-term recurrence rate of the ultrasound intervention group was lower than that of the conventional closed treatment group(P<0.05).Conclusion High-frequency ultrasound-guided interventional therapy can significantly improve the lesions of wrist and ankle joints in patients with RA.
作者
王雪瑞
孙晓峰
米秀琴
彭素芬
丰乃奇
王淑敏
WANG Xue-rui;SUN Xiao-feng;MI Xiu-qin(Department of Ultrasound,Ordos City Dongsheng District People's Hospital,Erdos Inner Mongolia 017000,China)
出处
《临床和实验医学杂志》
2019年第3期256-260,共5页
Journal of Clinical and Experimental Medicine
基金
国家重点研发计划资助项目(编号:2016YFC0104700)
关键词
类风湿关节炎
超声引导
介入治疗
随访
Rheumatoid arthritis
Ultrasound
Interventional therapy
Follow-up
